The Centers for Disease Control and Prevention (CDC) currently conducts National HIV Behavioral Surveillance (NHBS) in 25 metropolitan statistical areas (MSA) in the U.S., including the Seattle MSA. We propose to continue NHBS in the Seattle MSA from 2008 to 2010. The goal of NHBS in the Seattle MSA is to help direct and evaluate local HIV prevention efforts by maintaining an ongoing surveillance system to monitor sexual and drug-use behaviors, HIV prevention service access and utilization, and the prevalence and incidence of HIV among men who have sex with men (MSM), injection drug users (IDU), and high-risk heterosexuals (HET). To accomplish this goal, we propose to collaborate with CDC and other funded sites in implementation and [unreadable] evaluation of the continuation of NHBS in the three target populations according to CDC NHBS protocols. Specifically, we will conduct a formative assessment in each cycle to guide survey implementation in collaboration with a qualitative methods researcher from the University of Washington. We will also collaborate on survey development and implementation with Seattle area community-based organizations that are directly funded by CDC or funded by state or local funding through the community planning process for allocating federal HIV prevention funds. We will conduct a survey each year to assess HIV risk behaviors, HIV prevention services access and utilization, and HIV infection among Seattle-area MSM, IDU and HET. We will rotate the survey population each year and survey MSM in 2008, IDU in 2009, and HET in 2010. We will employ venue-based time-space sampling (VBS) and respondent-driven sampling (RDS) and complete surveys with 500 eligible participants each year. We will provide voluntary HIV counseling and testing to all NHBS participants in all three cycles to assess HIV seroprevalence and incidence (using the serological testing algorithm for recent HIV seroconversion, STARHS). We will conduct evaluations of the NHBS system including [unreadable] sampling strategies, and data collection methods to ensure that the system meets its goals, and provide recommendations for improving the quality, efficiency and usefulness of NHBS both locally and nationally. We will analyze data from all three NHBS surveys cycles and disseminate findings to the local HIV Prevention Planning Group, public health and community-based HIV prevention programs, and other audiences involved in HIV prevention planning, evaluation, and resource prioritization. [unreadable] [unreadable] [unreadable]